Rhinoplasty

A rhinoplasty is a cosmetic surgery procedure designed to change the appearance and shape of the nose. This procedure can also relieve functional breathing obstructions if a septoplasty is performed at the same time.

A rhinoplasty is performed for people who are unhappy with the appearance of their nose. The size and shape of the nose can be adjusted to better match the dimensions of the rest of the face. It is common for the bump on nose to be reduced and the tip of the nose to be refined. If a patient is having issues with breathing due to a deviated septum, this can be corrected at the time of the rhinoplasty.

When you come in for your initial consultation, you will meet with both Dr. Maloney and one of our clinical coordinators. Maloney Plastic Surgery is proud to be one of the only practices in Tucson, AZ to offer Vectra 3D (three dimensional) technology to our rhinoplasty patients. One of the first things we will do at your consultation is use VECTRA imaging technology to take a 3D image of your face. This technology will allow you to discuss your desired goals with Dr. Maloney when looking at the 3D image of your nose. Dr. Maloney will then perform a “rhinoplasty” on the 3D image and show you a realistic expectation of your final result post-surgery. After Vectra imaging, Dr. Maloney will examine you to determine if you are a good candidate for the procedure. He will also discuss details of the operation, show you before and after photos and answer any questions you may have. One of our patient coordinators will then review surgical fees, financing options and answer additional questions you may have. If you choose to have surgery with Dr. Maloney, you will return for another consultation about three weeks prior to your operation. At this pre-operative appointment Dr. Maloney will review the surgical plan with you as well as go through consent forms, review your Vectra pre-operative photographs and give you your prescriptions. One of our team members will take formal pre-operative photos and will review all of your surgical instructions. You will be given a packet of information so when you leave this appointment you are ready for surgery.

Once you have met with Dr. Maloney and have chosen a surgical date for your rhinoplasty, you should plan for your care and recovery after the operation. You will need to arrange a ride to and from the surgery center the day of surgery as well as arrange for someone to stay with you for the first twenty-four hours after surgery. You should take five days to three weeks off of work for this operation depending on the type of work you do. Please speak to a member of our team for more specific information. If your nasal bones need to be broken, you may have bruising that lasts up to three weeks. Should paperwork be required by your employer for your time off, please obtain it ahead of time and bring it to our office to complete. If you smoke, you must quit a minimum of three weeks before surgery. We suggest six to eight weeks, but three weeks is the minimum. Smokers heal more slowly and can have wound healing problems. If you smoke, the surgery may need to be cancelled or the surgical plan altered for your safety. If you take aspirin or another medication that causes your blood to thin, you should stop taking it three weeks before surgery. This is because it causes increased bleeding and therefore more bruising. If you are taking any diet pills (prescription or over-the-counter) or Metformin (a common diabetes medication), you should stop one week prior to surgery because of anesthesia risks.

At your pre-operative consultation with Dr. Maloney you will be given a map to the surgery center and your prescriptions. Get these prescriptions filled before surgery. Bags of frozen peas or corn work well as icepacks after your procedure. You need to stay hydrated. Have plenty of water or sports drinks around the house. We suggest you begin a stool softener as narcotic pain medication and anesthesia can make you constipated.

If you are having surgery before 10:00am, you cannot have anything to eat or drink after midnight, this includes water. If your procedure is scheduled for after 10:00am, we suggest drinking 16-24 ounces of Gatorade or other “sports drink” (the full sugar version, not diet) four hours before your operation. Studies have shown this will decrease dehydration and nausea post-surgery. You should not have anything to eat or drink other than the Gatorade. If you are taking prescribed medications, please get specific instructions regarding these medications from our team. Do not put any lotions, deodorant or make-up on the day of surgery. Please do not wear any jewelry to the surgery center. You should wear comfortable clothes that are easy to get on and off. A shirt that zips or buttons up the front is preferable, as are loose workout type pants or sweat pants. Bring your picture ID when you check into the surgery center. You will check in and then be taken back to the pre-operating area where Dr. Maloney will come and discuss the surgical plan, answer any additional questions you have and mark the surgical site. At this time you will meet the anesthesiologist and ask him/her any questions you may have.

A rhinoplasty procedure takes about two to three hours depending on the complexity. The anesthesiologist will put you to sleep under general anesthesia for this operation for your safety and comfort. Dr. Maloney will make an incision on the columella (the skin between your nostrils). He will then begin the procedure. Each rhinoplasty is different as each patient has individual needs. The tip of the nose may need to be refined, a hump on the top of the nose may need to be reduced or the nose may need to be narrowed. At times the septum may need to be straightened. Some patients require just one of these procedures, others require a combination. Depending on what procedures you require, packing may be placed inside the nose as a splint once your procedure is complete. A splint is placed on the outside of the nose for protection. You will wake up in the recovery room and be ready to go home in about an hour.

You should rest and eat a healthy diet with protein for optimal healing. Sleep with your head elevated for at least the first two days to reduce swelling and bruising. We suggest walking around your house every few hours to reduce the risk of blood clots. Your nose will be swollen and you may have bruising of your lower eyelids and cheeks after this procedure. The bruising can last about three weeks, so be patient during the recovery process. Swelling is mostly gone at about three weeks, however your final results will not be apparent for six to nine months. You may shower the day after surgery, but should avoiding getting the splint wet. You will return to the office for your first post-operative exam one to three days after surgery. The packing and splint is usually removed by day five. A low grade fever is common after any operation. If you have any questions during the recovery phase, please do not hesitate to call the office any time day or night.

Rhinoplasty has both aesthetic and health risks, and it is the patient’s personal decision whether the benefits outweigh those risks. More commonly seen risks include scars, bleeding, infection, asymmetry, excessive firmness, or changes in skin sensation. There are also more uncommon, but more complicated risks such as deep vein thrombosis. For a full list of risks, go to www.plasticsurgery.org.

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